減肥、運動與節食應有的正確觀念

Conceptualizing Obesity, Weight Reduction and Associated Psychopathology among Women

王耀群(Yao-Chung Wang)

《榮總護理》 17卷1期 (2000/03) Pp. 83-89

https://doi.org/10.6142/VGHN.17.1.83

摘要

體內代謝發生問題，使過多的脂肪堆積體內而形成的肥胖症，既與心理障礙無闕，亦非進食不良所致。
近代婦女受到西方文化影響及工作職場競爭因素，認爲矯美的身材能增加自我的體態形象、自尊及社交環境功能。
如以長期的飲食熱量限制來減輕體重，會造成個人心理障礙。暴食行爲一旦形成，即表示體內對營養素的迫切需要了，也顯示出個人已有焦慮和心理壓抑的情形或即將爆發精神性情結障礙。
神經性厭食症可由過度的劇烈運動所導致。以動物實驗室證實，過度的劇烈運動能刺激多巴垵(Dopamine)的反應增加，會吃得更少，運動得更激烈，在無法控制的體能耗損下，此種強迫性行爲至死方休。
研究發現，發展到成癮性人格、強迫性人格及厭食行爲的婦女，多與其幼年時父母要求其過度運動有關。
體重減輕可以外科手術或抑制食慾而獲致相當滿意的成績。近年來，加拿大多倫多醫院史宣稱可運用對正常飲食習慣的認知配以中等程度的運動的一種認知，行爲治療計畫來處理肥胖症，結果這些婦女不但體重減輕，且心理狀況及暴食行爲皆大爲改善，而身材更快速地趨向苗條。

並列摘要

Obesity is best described as a metabolic dysfunction resulting from excessive fat accumulation in the body. Obesity per se is genetically pre-determined and represents neither a psychiatric disorder, nor an eating disorder.
However, the current trend of having slim bodies among women is driven by interpersonal pressures, western cultural influences and competitions in their professions. Better physical fitness benefits a woman to improve self-image, self-esteem and heighten her functioning capacity in the social environment.
Losing weights through dieting with a long-term calorie restriction, on the contrary, is psychopathogenic. A bodily outcry is expressed by binging, which advocates the biological demand for more nutritional food. Her binging eating behaviors, serve also as an indicator for emerging symptoms of anxiety and depression, which lead to a full blown disorder.
Anorexia nervosa can be induced by excessive exercises. This comorbidity has been shown experimentally in association with an activation of the dopamine rewarding processes, addictive, compulsive behaviors and animal deaths due to continuous, uncontrollable physical activities and exhaustions.
In the study of anorexic women, the scientific interest has focused on the parental attitude of fostering excessives exercise on children. And this attitude leads to a later development in their addictive, obsessive-compulsive personality and anorexic behavior.
Weight reduction can not be satisfactorily achieved through surgical procedure or appetite suppressants. More recently, an obesity treatment program supported by the Toronto hospital announced its success in treating obese women by adopting a cognitive-behavioral therapeutic plan. By normalizing their eating habits and exercising moderately, those women lost weights, showed improvements on Beck depression scale (DBI), bulimia scores and significant reduction in their drive for thinness.